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1例内镜双猪尾支架脾内移位治疗腹腔镜袖状胃切除术后渗漏的病例。

A case of intrasplenic displacement of an endoscopic double-pigtail stent as a treatment for laparoscopic sleeve gastrectomy leak.

作者信息

Marchese Michele, Romano Lucia, Giuliani Antonio, Cianca Giovanni, Di Sibio Alessandra, Carlei Francesco, Amicucci Gianfranco, Schietroma Mario

机构信息

Department of Surgery, University of L'Aquila, L'Aquila, Italy.

Department of Surgery, University of L'Aquila, L'Aquila, Italy.

出版信息

Int J Surg Case Rep. 2018;53:367-369. doi: 10.1016/j.ijscr.2018.11.008. Epub 2018 Nov 13.

Abstract

INTRODUCTION

The most frequent and severe complication after laparoscopic sleeve gastrectomy is gastric leak. Nowadays, there is no specific standard recommendation for its management, but the endoscopic placement of a double-pigtail drain across the leak has been proven to be effective and minimally invasive. Stent displacement into the abdominal cavity is not common and intrasplenic migration is even more rare.

CASE PRESENTATION

We report a case of a 49-year-old woman with intrasplenic displacement of an endoscopic double-pigtail stent as a treatment for laparoscopic sleeve gastrectomy leak.

DISCUSSION

Pigtail drain migration involving the spleen is rare but may potentially expose the patient to the risk of parenchymal abscess or haemorrhage. Often the clinic does not indicate early this complication.

CONCLUSION

We underline the need for a close radiologic follow-up, regardless of clinical conditions, in all patients treated with double-pigtail drain and its early removal in case of migration.

摘要

引言

腹腔镜袖状胃切除术后最常见且严重的并发症是胃漏。目前,对于其处理尚无具体的标准建议,但经内镜放置双猪尾引流管穿过漏口已被证明是有效且微创的。支架移位至腹腔并不常见,而移位至脾内则更为罕见。

病例报告

我们报告一例49岁女性患者,其内镜双猪尾支架移位至脾内,该支架用于治疗腹腔镜袖状胃切除术后胃漏。

讨论

猪尾引流管移位至脾脏罕见,但可能使患者面临实质脓肿或出血风险。临床往往不能早期提示这一并发症。

结论

我们强调,对于所有接受双猪尾引流管治疗的患者,无论临床情况如何,都需要进行密切的影像学随访,若发生移位则应尽早取出引流管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ea2/6257903/d90039a5c342/gr1.jpg

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